Subgingival calculus has been recognized as a major cause of periodontitis, which is one of the main chronic infectious diseases of oral cavities and a principal cause of tooth loss in humans. Bacteria deposited in subgingival calculus or plaque cause gingival inflammation, function deterioration, and then periodontitis. However, subgingival calculus within the periodontal pocket is a complicated and potentially delicate structure to be detected with current dental armamentaria, namely dental x-rays and dental probes. Consequently, complete removal of subgingival calculus remains a challenge to periodontal therapies. In this study, the detection of subgingival calculus employing a multiphoton autofluorescence imaging method was characterized in comparison with a one-photon confocal fluorescence imaging technique. Feasibility of such a system was studied based on fluorescence response of gingiva, healthy teeth, and calculus with and without gingiva covered. The multiphoton fluorescence technology perceived the tissue-covered subgingival calculus that cannot be observed by the one-photon confocal fluorescence method.
[Show abstract][Hide abstract] ABSTRACT: Poor oral hygiene has been associated with an increased risk for cardiovascular disease. However, the association between preventive dentistry and cardiovascular risk reduction has remained undetermined. The aim of this study is to investigate the association between tooth scaling and the risk of cardiovascular events by using a nationwide, population-based study and a prospective cohort design.
Our analyses were conducted using information from a random sample of 1 million persons enrolled in the nationally representative Taiwan National Health Insurance Research Database. Exposed individuals consisted of all subjects who were aged ≥ 50 years and who received at least 1 tooth scaling in 2000. The comparison group of non-exposed persons consisted of persons who did not undergo tooth scaling and were matched to exposed individuals using propensity score matching by the time of enrollment, age, gender, history of coronary artery disease, diabetes, hypertension, and hyperlipidemia.
During an average follow-up period of 7 years, 10,887 subjects who had ever received tooth scaling (exposed group) and 10,989 age-, gender-, and comorbidity-matched subjects who had not received tooth scaling (non-exposed group) were enrolled. The exposed group had a lower incidence of acute myocardial infarction (1.6% vs 2.2%, P<.001), stroke (8.9% vs 10%, P=.03), and total cardiovascular events (10% vs 11.6%, P<.001) when compared with the non-exposed group. After multivariate analysis, tooth scaling was an independent factor associated with less risk of developing future myocardial infarction (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.57-0.85), stroke (HR, 0.85; 95% CI, 0.78-0.93), and total cardiovascular events (HR, 0.84; 95% CI, 0.77-0.91). Furthermore, when compared with the non-exposed group, increasing frequency of tooth scaling correlated with a higher risk reduction of acute myocardial infarction, stroke, and total cardiovascular events (P for trend<.001).
Tooth scaling was associated with a decreased risk for future cardiovascular events.
The American journal of medicine 04/2012; 125(6):568-75. DOI:10.1016/j.amjmed.2011.10.034 · 5.00 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives:
To clinically and histologically assess the gingival response to both silorane and methacrylate-based composite restoratives.
Seventy male patients, 25-40 years old, in need for either gingivectomy or crown lengthening around their maxillary premolars were classified into 7 groups (n=10). Group 1 patients (control, n =10) showed no cervical tooth defects although gingivectomy was required only for esthetic purpose. Premolar teeth of other patients showed a kind of subgingival cervical tooth defects on their buccal surfaces. Following thorough scaling and caries control, these defects were restored using either methacrylate or silorane-based composite restoratives (n= 30 for each restorative). For each restorative, clinical gingival assessment and histopathological examination of the cut gingival biopsies were carried out at 2, 4 and 8 weeks intervals (n=10). Statistical analysis using both ANOVA and t-test were used to stand on the significance of gingival scores recorded for different test groups.
No difference was detected between the gingival scores of all groups at 15 days. Although, a significant change in gingival scores (t-test, P<0.05) was noticed after 30 and 60 days contact with either methacrylate or silorane-based composites in groups 2 and 3, no sensible difference was declared between both restoratives. Most of the control gingival biopsies (75%) showed no pathological changes. The long term contact with methacrylate-based composite resulted in pathological deterioration of the epithelial keratinization, while the contact with silorane-based composite help the formation of ortho-keratin instead.
In spite of the fact that the silorane-based composite is more tolerable by the human gingiva, both methacrylate and silorane-based composites show inauspicious clinical and pathological signs following long term contact with the gingival tissues.
[Show abstract][Hide abstract] ABSTRACT: Objective: The clinical acceptance of restorative material normally depends on its biological
safety. This in vivo study considered the clinical and histological gingival response to
methacrylate and silorane‑based composites. Materials and Methods: Sixty patients
with sub‑gingival tooth defects were treated in two groups (n = 30) with Tetric N‑Ceram
and Filtek P90 composite restoratives with minimal finishing procedures. An additional
10 patients with pre‑existing gingival inflammation and no cervical tooth defects served
as control. The gingiva in contact was assessed clinically and histologically at 2, 4 and
8 week intervals. Results: A significant time‑dependent gingival response was noted
in both test groups (t‑test, P < 0.05). Inflammatory cell infiltrates, cellular degeneration,
epithelial hyperplasia, keratinization, and erosion were found in selected gingival biopsies.
Conclusion: The results confirmed that minimally finished subgingival composite restorations
contribute to significant histopathological changes to the contacting gingival tissues. However,
the silorane‑based composite elicited less severe gingival inflammatory symptoms in
comparison to the methacrylate‑based resin system.
06/2014; 3(2). DOI:10.4103/2278-0521.134853
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